EP2412337A1 - Intraocular implant with attachment elements - Google Patents

Intraocular implant with attachment elements Download PDF

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Publication number
EP2412337A1
EP2412337A1 EP11175244A EP11175244A EP2412337A1 EP 2412337 A1 EP2412337 A1 EP 2412337A1 EP 11175244 A EP11175244 A EP 11175244A EP 11175244 A EP11175244 A EP 11175244A EP 2412337 A1 EP2412337 A1 EP 2412337A1
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EP
European Patent Office
Prior art keywords
centering
lens
implant
capsule
posterior
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EP11175244A
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German (de)
French (fr)
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Philippe Sourdille
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Individual
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Individual
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1613Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • A61F2/1616Pseudo-accommodative, e.g. multifocal or enabling monovision
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1613Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1694Capsular bag spreaders therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0077Special surfaces of prostheses, e.g. for improving ingrowth
    • A61F2002/009Special surfaces of prostheses, e.g. for improving ingrowth for hindering or preventing attachment of biological tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2002/1681Intraocular lenses having supporting structure for lens, e.g. haptics

Definitions

  • the invention relates to the field of intraocular implants. These implants are intended to replace or correct the optical function of the lens. They include an optical part and lateral attachment loops called haptic part.
  • the invention particularly relates to an intraocular implant intended for implantation in the eye after capsulorhexis of the anterior capsule, especially when the posterior capsule of the crystalline sac is healthy.
  • Such implants are used, for example, for the treatment of cataracts. They are inserted into the crystalline sac after removal of the crystalline material.
  • the crystalline sac is composed of two spherical caps interconnected called anterior capsule and posterior capsule.
  • the crystalline sac is also called the capsular sac.
  • the surgeon cuts a generally circular orifice in the anterior capsule which is located on the side of the cornea. This operation is called “capsulorhexia” and the orifice is called “capsulorhexis” whose diameter varies from 4 to 7 mm.
  • the optical part of such implants for human eye is generally a circular lens with a diameter of 5.5 mm to 7 mm.
  • the equatorial diameter of the lens Most of the implants inserted in the crystalline sac rely on the connecting diameter between the anterior and posterior capsules called the equatorial diameter of the lens. However, the equatorial diameter of an adult human capable of being operated on cataract can vary from 8.2 mm to 10.8 mm. One of the difficulties of intra-lens implants is to be compatible with the diameters of human eyes.
  • the document US 5,476,512 discloses an intraocular implant for implantation in the posterior chamber of the eye after rupture of the posterior capsule of the lens sac.
  • the document US2006 / 047339 discloses a lens attachment collar which includes a groove in which the edge of the capsulorhexis is housed. The lens is in alignment with the capsule of the lens sac where said lens is attached. All the described haptics join the equatorial diameter of the crystalline sac.
  • the invention provides an intraocular implant that meets this need by improving the compatibility of the implant with a wider range of human eyes.
  • the immobilizing means comprise said inner guides, said flexible arms and at least a portion of the posterior surface of the lens, and are designed to tension the anterior capsule and the posterior capsule once the implant is in position.
  • the haptic portion comprises a plurality of centering / hooking elements and a reference circle along which a centering bottom of each of the centering / hooking elements extends, the reference circle being parallel and at an axial distance from the median plane. of the lens.
  • the centering / hooking elements each have one of said inner guides and an outer guide extending radially beyond the centering bottom and are intended to surround the anterior capsule respectively inside and outside the capsular bag, the around the orifice of the anterior capsule obtained by capsulohexia abutting the centering flanges.
  • the centering / hooking elements are centered by the diameter manufactured by the surgeon during capsulorhexis of the anterior capsule. This completely eliminates the variation of human eye diameters from one individual to another and the variation over time of the lens diameter due to postoperative scarring.
  • the inventor has indeed realized that great progress has been made in the operative procedures for capsulorhexis of the anterior capsule.
  • the surgeon can use for example guide rings to obtain a capsulorhexis well centered and dimensionally stable from one operation to another.
  • New femtosecond laser capsulohexis techniques also provide good diameter regularity and good centering. The inventor found that it was now possible to focus on capsulorhexis diameter.
  • the tension exerted by the flexible arms between the inner guides in support of the anterior capsule and at least a portion of the posterior surface resting on the posterior capsule makes it possible to keep apart the anterior capsule and the posterior capsule. This greatly reduces the migration of germinal cells that are initially located in the equatorial zone of the capsular bag. This reduces the risk of postoperative opacification of the posterior capsule.
  • Another advantage of such an implant is to preserve the posterior capsule when it is healthy. This makes it possible to avoid any contamination of the posterior chamber of the very sensitive eye during the placement of the intraocular implant.
  • each connecting arm extends up to a distance from the optical axis designed so that, once implanted in the eye, the implant remains at a predetermined, non-zero radial distance from the equatorial diameter of the crystalline sac. The fact that the haptic does not clog the area where the germinal cells are initially slows down their migration.
  • the outer guide, the centering bottom and the inner guide of each of the centering / hooking elements are of symmetrical shapes with respect to the same meridian plane of the centering element / hooking.
  • Meridian plane is any plane containing the optical axis of the lens.
  • the outer guide has a free distal end and a rounded facing the inner guide.
  • the axial distance between the distal end and the inner guide facing is less than the average thickness of an anterior capsule of human eye, so as to constitute a clipping means of the anterior capsule.
  • the implant is firmly clipped on the anterior capsule confers great security in case of re-intervention on the eye thus implanted. Indeed, it can happen that cells migrate between the lens and the posterior capsule and opacify this capsule. Recovery operations of this secondary opacification can be undertaken to cut through a laser passing through the implant already installed, the portion of the posterior capsule located in the center just needed to restore visual acuity. The periphery of the posterior surface of the lens may continue to contribute to the immobilization of the implant in the eye.
  • the fact that the implant is firmly clipped and centered on the anterior capsule and plated on the posterior capsule reduces the risk of displacement of the implant after opening the posterior capsule.
  • the flexibility of the connecting arms also facilitates insertion of the implant by extending the arms to introduce the implant into an insertion device in the crystalline sac.
  • the haptic portion is constituted by a plurality of hooking arms, each constituted by one of the centering / hooking elements and by a single connecting arm to the lens, also of symmetrical shape with respect to the meridian plane of the centering / latching element.
  • the lens has a cylindrical lateral edge and a posterior face intended to be plated. against the posterior capsule of the eye, the cylindrical edge and the posterior face being connected by a sharp stop.
  • Such implants are known as "square edge implants".
  • the sharp edge, or square edge is an obstacle to the propagation of germinal cells along the posterior capsule.
  • the invention is particularly advantageous for such implants. Indeed, the current trend is to reduce the thickness of the lens and therefore also reduce the axial height of the cylindrical edge.
  • current polishing techniques of the implant may increase the radius of curvature of the square edge, thereby decreasing the stopping effect of cell migration.
  • the inventor has realized that the radius of curvature of the sharp edge is not the only parameter to be taken into account for the effectiveness of the cell propagation barrier.
  • the inventor has discovered that the plating pressure of the periphery of the lens against the posterior capsule is also critical.
  • the combination of centering / hooking elements with flexible connecting arms and "square edges" can improve the efficiency of the latter even in the case of thinner lenses.
  • the diameter of capsulorhexis is very close to that of the lens.
  • the connecting arms exert a pressure force substantially above said "square edges". It is understood that the implants bearing on the equatorial diameter of the lens are less well pressed against the posterior capsule than those of the invention.
  • the cylindrical lateral edge extends axially between 150 and 300 ⁇ m.
  • the advantage of the invention mentioned above is particularly evident for such thinned lens implants.
  • each connecting arm is connected to an anterior face of the lens located on the same side of the median plane as the reference circle. This allows the posterior and lateral edges of the haptic portion to be unaffected by the presence of the arms. This is particularly advantageous in the case of so-called "square edge" implants.
  • each connecting arm is connected to a peripheral zone of the lens. This prevents the arms from altering the optical behavior of the implant.
  • each connecting arm extends less than 4.2 mm from the optical axis. This makes it possible to prevent the connecting arms, in the implanted state, from being in contact with the equatorial diameter of the capsular bag which is the place where the sources of germinal cells responsible for opacification of the lens are.
  • the attachment elements have a section in a meridian plane having the shape of a U or a V, the outer guide extends over a radial distance of 0.6 to 2 mm.
  • the lens and the haptic portion form a one-piece assembly of hydrophilic synthetic material.
  • the eye 1 comprises a cornea 2, an iris 3, a crystalline sac 4 connected to the eye by a zonule 5, and a posterior chamber 6 of the eye 1 located at the rear of the crystalline sac 4.
  • the sac lens 4 consists of an anterior capsule 7 on the side of the iris 3 and a posterior capsule 8, both hemispherical and connected in an equatorial diameter 9.
  • the eye 1 is shown after a phacoemulsification operation during which the crystalline material located in the crystalline sac 4 has been destroyed and removed.
  • a circular orifice was made in the anterior capsule 7 by an operation called capsulorhexis.
  • This orifice has a periphery 10 called capsulorhexis 10.
  • An implant 11 is constituted by a circular monobloc lens 12 and extending symmetrically along a median plane 13.
  • the lens 12 has an optical axis 14 perpendicular to the median plane 13.
  • the implant has a haptic portion 15 constituted by four attachment arms 16.
  • Each of the attachment arms 16 is constituted by an outer guide 17, a centering bottom 18, an inner guide 19 and a connecting arm 20 which is fixed on a peripheral portion 21 of the lens 12 by a foot 22.
  • the outer guide 17, the centering base 18 and the inner guide 19 constitute a hooking / centering element 23 having substantially the shape of an open U in a radial direction outside and surrounding the anterior capsule 7 bypassing the capsulorhexis diameter 10.
  • the connecting arm 20 has a shape C, in the extension of the inner guide 19 and whose opening is directed towards the optical axis 14.
  • each of the centering funds 18 are in the free state before implantation in the eye 1, located along a reference circle 24 (visible in FIG. figure 2 ) parallel and remote from the median plane 13 so as to correspond to the capsulorhexis diameter 10 once implanted.
  • the outer guide 17 has on its face facing the inner guide 19, a rounded 25 forming a clipping bead.
  • the lens 12 is a "square-edge" type lens in that it has an axially extending cylindrical lateral rim 30 having a relatively spherical rear face 31, a sharp connecting edge 32 preventing the propagation of the germinal cells from the equatorial diameter 9 in order to avoid propagation between the posterior face 31 of the lens 12 and the posterior capsule 8.
  • Each of the legs 22 of the latching arms 16 extends on the front face 33 of the lens 12 so as not to affect the geometry of the connecting edge 32.
  • the connecting arms 20 are slightly compressed axially so as to tension the anterior capsule 7 and the posterior capsule 8 and to reinforce the plating force of the live stop 32 against the posterior capsule 8.
  • each of the four attachment arms 16 extend symmetrically with respect to four meridian half-planes 26 passing through the optical axis 14 and each inclined by 30 ° with respect to a plane of symmetry 27 with respect to which the lens 12 is folded to facilitate insertion into the eye with an injection syringe.
  • the attachment arms 16 which are flexible extend on the right and the left of the Figure 2 so as not to exceed the outer diameter 28 of the lens 12.
  • each of the attachment arms 16 resume their rest position as illustrated in FIGS. Figures 1 and 2 .
  • the centering funds 18 of each of the centering / hooking elements 23 are located along the reference circle 24.
  • the surgeon can, with a tool, catch each of the attachment arms and bring it each towards the optical axis 14 so that the outer guide 17 can emerge from the capsular bag 4 and that the centering bottom 18 comes then bearing on the periphery 10 of the orifice obtained by capsulorhexie.
  • Each of the attachment arms 16 has a width which gradually decreases from 9 mm to 5 mm wide as the foot 22. The thickness also varies from 1 mm to 0.6 mm. It is understood that such attachment arms have a stiffness opposing the axial displacement of the centering / latching element 23 less than the lateral stiffness opposing a displacement of the same centering element 23 in a plane parallel to the median plane 13. Such a configuration allows both a good centering of the lens 12 relative to the circumference capsulorhexis 10 while allowing a slight axial tension of the posterior and anterior chambers 8, 7.
  • a second embodiment comprises four attachment arms 40 located at 90 ° from each other and having a large width, for example of the order of 14 mm. This reinforces the quality of the centering of the lens 12 with respect to the capsulorhexis 10.
  • the connecting leg 42 of the attachment arm 40 extends laterally on either side of the meridian plane so as to encircle the connecting leg 42 as close as possible to the peripheral zone 21 of the lens 12.
  • a third embodiment consists of several attachment arms 50 paired together, two by two, by a bridge 51 for connecting the outer guides 52.
  • This embodiment has both more flexible attachment arms susceptible to bend further to facilitate insertion into the capsular bag while allowing the surgeon to simultaneously position two latching arms 50 due to the connecting bridge 51.
  • the connecting arms 60 are also paired in pairs while being even more flexible.
  • each of the connecting arms can be varied as well as their shape.
  • the attachment arms 16, 50, 60 could also be equipped with laterally widened connecting foot and reduced radially.
  • the number of attachment arms 6, or 40, or 50 may be for example three or six.

Abstract

The implant (11) has a haptic part (15) comprising a centering or hanging element (23) and a reference circle along which a centering base (18) of the element is extended. The circle is at an axial distance from a median plane (13) of circular monoblock lens (12). The element has an inner guide (19) and an outer guide (17) extending radially above the centering base. The guides surround the anterior capsule respectively at inner and outer of a crystalline lens bag (4). Circumference (10) of orifice of the anterior capsule obtained by capsulorhexis is supported on the base.

Description

DOMAINE DE L'INVENTIONFIELD OF THE INVENTION

L'invention concerne le domaine des implants intraoculaires. Ces implants sont destinés à remplacer ou à corriger la fonction optique du cristallin. Ils comprennent une partie optique et des anses latérales de fixation appelées partie haptique.The invention relates to the field of intraocular implants. These implants are intended to replace or correct the optical function of the lens. They include an optical part and lateral attachment loops called haptic part.

L'invention concerne en particulier un implant intraoculaire destiné à une implantation dans l'oeil après une capsulorhexie de la capsule antérieure, notamment lorsque la capsule postérieure du sac cristallin est saine.The invention particularly relates to an intraocular implant intended for implantation in the eye after capsulorhexis of the anterior capsule, especially when the posterior capsule of the crystalline sac is healthy.

ETAT DE LA TECHNIQUE ANTERIEURESTATE OF THE PRIOR ART

De tels implants sont utilisés, par exemple, pour le traitement de la cataracte. Ils sont insérés dans le sac cristallinien après ablation du matériau cristallinien. Le sac cristallinien est composé de deux calottes sphériques reliées entre elles appelées capsule antérieure et capsule postérieure. Le sac cristallinien est également appelé sac capsulaire. Avant insertion de l'implant, le chirurgien découpe un orifice généralement circulaire dans la capsule antérieure qui est située du côté de la cornée. Cette opération est appelée « capsulorhexie » et l'orifice réalisé est appelé « capsulorhexis » dont le diamètre varie de 4 à 7 mm.Such implants are used, for example, for the treatment of cataracts. They are inserted into the crystalline sac after removal of the crystalline material. The crystalline sac is composed of two spherical caps interconnected called anterior capsule and posterior capsule. The crystalline sac is also called the capsular sac. Before insertion of the implant, the surgeon cuts a generally circular orifice in the anterior capsule which is located on the side of the cornea. This operation is called "capsulorhexia" and the orifice is called "capsulorhexis" whose diameter varies from 4 to 7 mm.

La partie optique de tels implants pour oeil humain est généralement une lentille circulaire d'un diamètre de 5,5 mm à 7 mm.The optical part of such implants for human eye is generally a circular lens with a diameter of 5.5 mm to 7 mm.

La plupart des implants insérés dans le sac cristallinien prennent appui sur le diamètre de raccordement entre les capsules antérieure et postérieure appelé diamètre équatorial du cristallin. Or, le diamètre équatorial d'un individu humain adulte susceptible d'être opéré de la cataracte peut varier de 8,2 mm à 10,8 mm. Une des difficultés des implants intra cristalliniens est d'être compatibles avec les diamètres des yeux humains.Most of the implants inserted in the crystalline sac rely on the connecting diameter between the anterior and posterior capsules called the equatorial diameter of the lens. However, the equatorial diameter of an adult human capable of being operated on cataract can vary from 8.2 mm to 10.8 mm. One of the difficulties of intra-lens implants is to be compatible with the diameters of human eyes.

Par ailleurs, le document US 5 476 512 décrit un implant intraoculaire pour une implantation dans la chambre postérieure de l'oeil après une rupture de la capsule postérieure du sac cristallinien. Le document US2006/047339 décrit un collier de fixation de lentille qui comprend une gorge dans laquelle se loge le bord du capsulorhexis. La lentille est dans l'alignement de la capsule du sac cristallinien où ladite lentille est attachée. Toutes les haptiques décrites rejoingnent le diamètre équatorial du sac cristallinien.In addition, the document US 5,476,512 discloses an intraocular implant for implantation in the posterior chamber of the eye after rupture of the posterior capsule of the lens sac. The document US2006 / 047339 discloses a lens attachment collar which includes a groove in which the edge of the capsulorhexis is housed. The lens is in alignment with the capsule of the lens sac where said lens is attached. All the described haptics join the equatorial diameter of the crystalline sac.

OBJET ET RESUME DE L'INVENTION OBJECT AND SUMMARY OF THE INVENTION

L'invention propose un implant intraoculaire qui répond à ce besoin en améliorant la compatibilité de l'implant avec une gamme plus large d'yeux humains.The invention provides an intraocular implant that meets this need by improving the compatibility of the implant with a wider range of human eyes.

Selon un mode de réalisation, l'implant intraoculaire destiné à une implantation dans l'oeil après une capsulorhexie de la capsule antérieure, comprenant :

  • une lentille unique s'étendant dans un plan médian et présentant un axe optique normal au plan médian ainsi qu'une face postérieure destinée à être plaquée sur la capsule postérieure,
  • l'implant comprenant en outre une partie haptique comprenant des guides intérieurs reliés à la lentille par un ou plusieurs bras de raccordement flexibles,
l'implant présentant des moyens d'immobilisation de la lentille dans le sac capsulaire de l'oeil,According to one embodiment, the intraocular implant intended for implantation in the eye after capsulorhexis of the anterior capsule, comprising:
  • a single lens extending in a median plane and having an optical axis normal to the median plane and a posterior surface intended to be plated on the posterior capsule,
  • the implant further comprising a haptic portion comprising inner guides connected to the lens by one or more flexible connecting arms,
the implant having means for immobilizing the lens in the capsular bag of the eye,

Selon l'invention, les moyens d'immobilisation comprennent lesdits guides intérieurs, lesdits bras flexibles et au moins une portion de la face postérieure de la lentille, et sont conçus pour tendre la capsule antérieure et la capsule postérieure une fois que l'implant est en position. La partie haptique comprend une pluralité d'éléments de centrage/accrochage et un cercle de référence le long duquel s'étend un fond de centrage de chacun des éléments de centrage/accrochage, le cercle de référence étant parallèle et à distance axiale du plan médian de la lentille. Les éléments de centrage/accrochage présentent chacun un desdits guides intérieurs et un guide extérieur s'étendant radialement au-delà du fond de centrage et sont destinés à entourer la capsule antérieure respectivement à l'intérieur et à l'extérieur du sac capsulaire, le pourtour de l'orifice de la capsule antérieure obtenu par capsulorhexie venant en appui sur les fonds de centrage.According to the invention, the immobilizing means comprise said inner guides, said flexible arms and at least a portion of the posterior surface of the lens, and are designed to tension the anterior capsule and the posterior capsule once the implant is in position. The haptic portion comprises a plurality of centering / hooking elements and a reference circle along which a centering bottom of each of the centering / hooking elements extends, the reference circle being parallel and at an axial distance from the median plane. of the lens. The centering / hooking elements each have one of said inner guides and an outer guide extending radially beyond the centering bottom and are intended to surround the anterior capsule respectively inside and outside the capsular bag, the around the orifice of the anterior capsule obtained by capsulohexia abutting the centering flanges.

On comprend qu'un tel implant permet à la fois de sécuriser le centrage de l'implant, indépendamment des fluctuations du diamètre équatoriale du sac cristallinien, et de réduire le risque d'opacification secondaire.It is understood that such an implant makes it possible both to secure the centering of the implant, independently of fluctuations in the equatorial diameter of the crystalline sac, and to reduce the risk of secondary opacification.

En effet, les éléments de centrage/accrochage sont centrés par le diamètre fabriqué par le chirurgien lors de la capsulorhexie de la capsule antérieure. Cela permet de s'affranchir totalement de la variation de diamètres d'yeux humains d'un individu à l'autre et de la variation dans le temps du diamètre du cristallin due à la cicatrisation post opératoire. L'inventeur s'est en effet rendu compte que de gros progrès ont été réalisés dans les procédés opératoires de capsulorhexie de la capsule antérieure. Le chirurgien peut utiliser par exemple des anneaux de guidage pour obtenir un capsulorhexis bien centré et de dimensions stables d'une opération à l'autre. De nouvelles techniques de capsulorhexie par laser femtoseconde permettent également une bonne régularité de diamètre et un bon centrage. L'inventeur a trouvé qu'il devenait dorénavant possible de se centrer sur le diamètre capsulorhexis.Indeed, the centering / hooking elements are centered by the diameter manufactured by the surgeon during capsulorhexis of the anterior capsule. This completely eliminates the variation of human eye diameters from one individual to another and the variation over time of the lens diameter due to postoperative scarring. The inventor has indeed realized that great progress has been made in the operative procedures for capsulorhexis of the anterior capsule. The surgeon can use for example guide rings to obtain a capsulorhexis well centered and dimensionally stable from one operation to another. New femtosecond laser capsulohexis techniques also provide good diameter regularity and good centering. The inventor found that it was now possible to focus on capsulorhexis diameter.

De plus, la tension exercée par les bras flexibles entre les guides intérieurs en appui du la capsule antérieure et au moins une portion de la face postérieure en appui sur la capsule postérieure permet de maintenir écarté l'une de l'autre la capsule antérieure et la capsule postérieure. Cela réduit fortement la migration des cellules germinatives qui se situes initialement dans la zone équatoriale du sac capsulaire. Cela réduit les risques d'opacification post opératoire de la capsule postérieure.In addition, the tension exerted by the flexible arms between the inner guides in support of the anterior capsule and at least a portion of the posterior surface resting on the posterior capsule makes it possible to keep apart the anterior capsule and the posterior capsule. This greatly reduces the migration of germinal cells that are initially located in the equatorial zone of the capsular bag. This reduces the risk of postoperative opacification of the posterior capsule.

Un autre avantage d'un tel implant est de conserver la capsule postérieure lorsqu'elle est saine. Cela permet d'éviter toute contamination de la chambre postérieure de l'oeil très sensible lors de la pose de l'implant intraoculaire.Another advantage of such an implant is to preserve the posterior capsule when it is healthy. This makes it possible to avoid any contamination of the posterior chamber of the very sensitive eye during the placement of the intraocular implant.

Selon un mode de réalisation, chaque bras de raccordement s'étend jusqu'à une distance de l'axe optique conçue pour qu'une fois implanté dans l'oeil, l'implant reste à une distance radiale prédéterminée non nulle du diamètre équatorial du sac cristallinien. Le fait que l'haptique ne ouche pas la zone où se trouve initialement les cellules germinatives permet de ralentir encore leur migration.According to one embodiment, each connecting arm extends up to a distance from the optical axis designed so that, once implanted in the eye, the implant remains at a predetermined, non-zero radial distance from the equatorial diameter of the crystalline sac. The fact that the haptic does not clog the area where the germinal cells are initially slows down their migration.

Avantageusement, le guide extérieur, le fond de centrage et le guide intérieur de chacun des éléments de centrage/accrochage sont de formes symétriques par rapport à un même plan méridien de l'élément de centrage/accrochage. On appelle plan méridien tout plan contenant l'axe optique de la lentille.Advantageously, the outer guide, the centering bottom and the inner guide of each of the centering / hooking elements are of symmetrical shapes with respect to the same meridian plane of the centering element / hooking. Meridian plane is any plane containing the optical axis of the lens.

Avantageusement, le guide extérieur présente une extrémité distale libre et un arrondi en regard du guide intérieur. La distance axiale entre l'extrémité distale et le guide intérieur en regard est inférieure à l'épaisseur moyenne d'une capsule antérieure d'oeil humain, de façon à constituer un moyen de clipsage de la capsule antérieure.Advantageously, the outer guide has a free distal end and a rounded facing the inner guide. The axial distance between the distal end and the inner guide facing is less than the average thickness of an anterior capsule of human eye, so as to constitute a clipping means of the anterior capsule.

Le fait que l'implant soit solidement clipsé sur la capsule antérieure confère une grande sécurité en cas de ré-intervention sur l'oeil ainsi implanté. En effet, il peut arriver que des cellules migrent entre la lentille et la capsule postérieure et opacifient cette capsule. Des opérations de récupération de cette opacification secondaire peuvent être entreprises pour découper par un laser traversant l'implant déjà installé, la partie de la capsule postérieure située au centre de manière juste nécessaire à restaurer l'acuité visuelle. La périphérie de la face postérieure de la lentille peut continuer à contribuer à l'immobilisation de l'implant dans l'oeil. Le fait que l'implant soit solidement clipsé et centré sur la capsule antérieure et plaqué sur la capsule postérieure réduit les risques de déplacement de l'implant après ouverture de la capsule postérieure.The fact that the implant is firmly clipped on the anterior capsule confers great security in case of re-intervention on the eye thus implanted. Indeed, it can happen that cells migrate between the lens and the posterior capsule and opacify this capsule. Recovery operations of this secondary opacification can be undertaken to cut through a laser passing through the implant already installed, the portion of the posterior capsule located in the center just needed to restore visual acuity. The periphery of the posterior surface of the lens may continue to contribute to the immobilization of the implant in the eye. The fact that the implant is firmly clipped and centered on the anterior capsule and plated on the posterior capsule reduces the risk of displacement of the implant after opening the posterior capsule.

La flexibilité des bras de raccordement facilite aussi l'insertion de l'implant en permettant d'étendre les bras pour introduire l'implant dans un dispositif d'insertion dans le sac cristallinien.The flexibility of the connecting arms also facilitates insertion of the implant by extending the arms to introduce the implant into an insertion device in the crystalline sac.

Avantageusement, la partie haptique est constituée par une pluralité de bras d'accrochages, constitués chacun par l'un des éléments de centrage/accrochage et par un unique bras de raccordement à la lentille, lui aussi de forme symétrique par rapport au plan méridien de l'élément de centrage/accrochage.Advantageously, the haptic portion is constituted by a plurality of hooking arms, each constituted by one of the centering / hooking elements and by a single connecting arm to the lens, also of symmetrical shape with respect to the meridian plane of the centering / latching element.

Selon un mode de réalisation, la lentille présente un bord latéral cylindrique et une face postérieure destinée à être plaquée contre la capsule postérieure de l'oeil, le bord cylindrique et la face postérieure étant raccordés par une arrête vive.According to one embodiment, the lens has a cylindrical lateral edge and a posterior face intended to be plated. against the posterior capsule of the eye, the cylindrical edge and the posterior face being connected by a sharp stop.

De tels implants sont connus sous l'appellation « d'implants à bords carrés ». L'arrête vive, ou bord carré, constitue un obstacle à la propagation des cellules germinatives le long le long de la capsule postérieure. L'invention est particulièrement avantageuse pour de tels implants. En effet, la tendance actuelle est de réduire l'épaisseur de la lentille et donc de réduire également la hauteur axiale du bord cylindrique. D'autre part, les techniques actuelles de polissage de l'implant risquent d'augmenter le rayon de courbure du bord carré, diminuant d'autant l'effet d'arrêt de la migration cellulaire. L'inventeur s'est rendu compte que le rayon de courbure de l'arrête vive n'est pas le seul paramètre à prendre en compte pour l'efficacité de la barrière à la propagation des cellules. L'inventeur a découvert que la pression de plaquage de la périphérie de la lentille contre la capsule postérieure est également déterminante. Ainsi, la combinaison des éléments du centrage/accrochage avec des bras de raccordement flexibles et des « bords carrés » permet d'améliorer l'efficacité de ces derniers même dans le cas de lentilles plus minces. En effet, le diamètre du capsulorhexis est très voisin de celui de la lentille. Donc, en prenant appui sur la capsule antérieure, les bras de raccordement exercent un effort de pression sensiblement au-dessus desdits « bords carrés ». On comprend que les implants prenant appui sur le diamètre équatorial du cristallin sont moins bien plaqués contre la capsule postérieure que ceux de l'invention.Such implants are known as "square edge implants". The sharp edge, or square edge, is an obstacle to the propagation of germinal cells along the posterior capsule. The invention is particularly advantageous for such implants. Indeed, the current trend is to reduce the thickness of the lens and therefore also reduce the axial height of the cylindrical edge. On the other hand, current polishing techniques of the implant may increase the radius of curvature of the square edge, thereby decreasing the stopping effect of cell migration. The inventor has realized that the radius of curvature of the sharp edge is not the only parameter to be taken into account for the effectiveness of the cell propagation barrier. The inventor has discovered that the plating pressure of the periphery of the lens against the posterior capsule is also critical. Thus, the combination of centering / hooking elements with flexible connecting arms and "square edges" can improve the efficiency of the latter even in the case of thinner lenses. Indeed, the diameter of capsulorhexis is very close to that of the lens. Thus, by pressing on the anterior capsule, the connecting arms exert a pressure force substantially above said "square edges". It is understood that the implants bearing on the equatorial diameter of the lens are less well pressed against the posterior capsule than those of the invention.

Avantageusement, le bord latéral cylindrique s'étend axialement entre 150 et 300 µm. L'avantage de l'invention évoqué plus haut est particulièrement manifeste pour de tels implants à lentille amincie.Advantageously, the cylindrical lateral edge extends axially between 150 and 300 μm. The advantage of the invention mentioned above is particularly evident for such thinned lens implants.

Avantageusement, chaque bras de raccordement est relié à une face antérieure de la lentille située du même côté du plan médian que le cercle de référence. Cela permet que la face postérieure et le bord latéral de la partie haptique ne soit pas modifiée par la présence des bras. Cela est particulièrement avantageux dans le cas d'implants dits « à bords carrés ».Advantageously, each connecting arm is connected to an anterior face of the lens located on the same side of the median plane as the reference circle. This allows the posterior and lateral edges of the haptic portion to be unaffected by the presence of the arms. This is particularly advantageous in the case of so-called "square edge" implants.

Avantageusement, chaque bras de raccordement est relié à une zone périphérique de la lentille. Cela permet d'éviter que les bras modifient le comportement optique de l'implant.Advantageously, each connecting arm is connected to a peripheral zone of the lens. This prevents the arms from altering the optical behavior of the implant.

Avantageusement, chaque bras de raccordement s'étend à moins de 4,2 mm de l'axe optique. Cela permet d'éviter que les bras de raccordement, à l'état implantés, ne soient en contact avec le diamètre équatorial du sac capsulaire qui est le lieu où se trouvent les sources de cellules germinatives responsables de l'opacification du cristallin.Advantageously, each connecting arm extends less than 4.2 mm from the optical axis. This makes it possible to prevent the connecting arms, in the implanted state, from being in contact with the equatorial diameter of the capsular bag which is the place where the sources of germinal cells responsible for opacification of the lens are.

Selon un mode de réalisation, les éléments d'accrochage présentent une section dans un plan méridien ayant la forme d'un U ou d'un V, le guide extérieur d'étendent sur une distance radiale de 0.6 à 2 mm.According to one embodiment, the attachment elements have a section in a meridian plane having the shape of a U or a V, the outer guide extends over a radial distance of 0.6 to 2 mm.

Selon un mode de réalisation, la lentille et la partie haptique forment un ensemble monobloc en matériau synthétique hydrophile.According to one embodiment, the lens and the haptic portion form a one-piece assembly of hydrophilic synthetic material.

BREVE DESCRIPTION DES FIGURESBRIEF DESCRIPTION OF THE FIGURES

D'autres caractéristiques et avantages de l'invention apparaîtront à la lecture de la description qui suit de plusieurs modes de réalisation de l'invention, donnés à titre d'exemples non limitatifs. La description se réfère aux dessins annexés sur lesquels :

  • la figure 1 est une vue latérale d'un premier mode de réalisation d'implant intraoculaire selon la flèche F de la figure 2, et son implantation dans un oeil vu en coupe,
  • la figure 2 est une vue de dessus du premier mode de réalisation,
  • la figure 3 est une vue de dessus d'un deuxième mode de réalisation,
  • la figure 4 est une vue de dessus d'un troisième mode de réalisation, et
  • la figure 5 est une vue de dessus d'un quatrième mode de réalisation.
Other features and advantages of the invention will appear on reading the following description of several embodiments of the invention, given by way of non-limiting examples. The description refers to the accompanying drawings in which:
  • the figure 1 is a side view of a first embodiment of intraocular implant according to the arrow F of the figure 2 , and its implantation in an eye seen in section,
  • the figure 2 is a top view of the first embodiment,
  • the figure 3 is a view from above of a second embodiment,
  • the figure 4 is a top view of a third embodiment, and
  • the figure 5 is a top view of a fourth embodiment.

DESCRIPTION DETAILLEEDETAILED DESCRIPTION

Comme illustré en Figure 1, l'oeil 1 comprend une cornée 2, un iris 3, un sac cristallinien 4 relié à l'oeil par une zonule 5, et une chambre postérieure 6 de l'oeil 1 située à l'arrière du sac cristallinien 4. Le sac cristallinien 4 est constitué d'une capsule antérieure 7 du côté de l'iris 3 et d'une capsule postérieure 8, hémisphériques toutes les deux et reliées en un diamètre équatorial 9.As illustrated in Figure 1 the eye 1 comprises a cornea 2, an iris 3, a crystalline sac 4 connected to the eye by a zonule 5, and a posterior chamber 6 of the eye 1 located at the rear of the crystalline sac 4. The sac lens 4 consists of an anterior capsule 7 on the side of the iris 3 and a posterior capsule 8, both hemispherical and connected in an equatorial diameter 9.

L'oeil 1 est représenté après une opération de phacoémulsification au cours de laquelle le matériau cristallinien situé dans le sac cristallinien 4 a été détruit et retiré. De plus, un orifice circulaire a été ménagé dans la capsule antérieure 7 par une opération appelée capsulorhexie. Cet orifice présente un pourtour 10 appelé capsulorhexis 10.The eye 1 is shown after a phacoemulsification operation during which the crystalline material located in the crystalline sac 4 has been destroyed and removed. In addition, a circular orifice was made in the anterior capsule 7 by an operation called capsulorhexis. This orifice has a periphery 10 called capsulorhexis 10.

Un implant 11 est constitué par une lentille 12 monobloc circulaire et s'étendant symétriquement le long d'un plan médian 13. La lentille 12 présente un axe optique 14 perpendiculaire au plan médian 13.An implant 11 is constituted by a circular monobloc lens 12 and extending symmetrically along a median plane 13. The lens 12 has an optical axis 14 perpendicular to the median plane 13.

L'implant présente une partie haptique 15 constituée par quatre bras d'accrochage 16. Chacun des bras d'accrochage 16 est constitué par un guide extérieur 17, un fond de centrage 18, un guide intérieur 19 et un bras de raccordement 20 lequel est fixé sur une partie périphérique 21 de la lentille 12 par un pied 22. Le guide extérieur 17, le fond de centrage 18 et le guide intérieur 19 constituent un élément d'accrochage/centrage 23 ayant sensiblement la forme d'un U ouvert dans une direction radiale extérieure et entourant la capsule antérieure 7 en contournant le diamètre capsulorhexis 10. Le bras de raccordement 20 présente une forme en C, dans le prolongement du guide intérieur 19 et dont l'ouverture est dirigée vers l'axe optique 14.The implant has a haptic portion 15 constituted by four attachment arms 16. Each of the attachment arms 16 is constituted by an outer guide 17, a centering bottom 18, an inner guide 19 and a connecting arm 20 which is fixed on a peripheral portion 21 of the lens 12 by a foot 22. The outer guide 17, the centering base 18 and the inner guide 19 constitute a hooking / centering element 23 having substantially the shape of an open U in a radial direction outside and surrounding the anterior capsule 7 bypassing the capsulorhexis diameter 10. The connecting arm 20 has a shape C, in the extension of the inner guide 19 and whose opening is directed towards the optical axis 14.

On comprend que chacun des fonds 18 de centrage sont à l'état libre avant implantation dans l'oeil 1, situé le long d'un cercle de référence 24 (visible en figure 2) parallèle et à distance du plan médian 13 de manière à correspondre au diamètre capsulorhexis 10 une fois implanté.It is understood that each of the centering funds 18 are in the free state before implantation in the eye 1, located along a reference circle 24 (visible in FIG. figure 2 ) parallel and remote from the median plane 13 so as to correspond to the capsulorhexis diameter 10 once implanted.

Le guide extérieur 17 présente, sur sa face en regard avec le guide intérieur 19, un arrondi 25 formant un bourrelet de clipsage.The outer guide 17 has on its face facing the inner guide 19, a rounded 25 forming a clipping bead.

La lentille 12 est une lentille de type « à bords carrés » en ce sens qu'elle présente un rebord latéral 30 cylindrique s'étendant axialement et présentant par rapport à une face postérieure 31 partiellement sphérique, une arrête vive de raccordement 32 faisant obstacle à la propagation des cellules germinatives en provenance du diamètre équatorial 9 afin d'éviter une propagation entre la face postérieure 31 de la lentille 12 et la capsule postérieure 8.The lens 12 is a "square-edge" type lens in that it has an axially extending cylindrical lateral rim 30 having a relatively spherical rear face 31, a sharp connecting edge 32 preventing the propagation of the germinal cells from the equatorial diameter 9 in order to avoid propagation between the posterior face 31 of the lens 12 and the posterior capsule 8.

Chacun des pieds 22 des bras d'accrochage 16 s'étend sur la face antérieure 33 de la lentille 12 de manière à ne pas affecter la géométrie de l'arrête de raccordement 32.Each of the legs 22 of the latching arms 16 extends on the front face 33 of the lens 12 so as not to affect the geometry of the connecting edge 32.

Lorsque l'implant 11 est introduit dans le sac capsulaire 4, les bras de raccordement 20 sont légèrement comprimés axialement de manière à tendre la capsule antérieure 7 et la capsule postérieure 8 et à renforcer l'effort de plaquage de l'arrête vive 32 contre la capsule postérieure 8.When the implant 11 is introduced into the capsular bag 4, the connecting arms 20 are slightly compressed axially so as to tension the anterior capsule 7 and the posterior capsule 8 and to reinforce the plating force of the live stop 32 against the posterior capsule 8.

Comme illustré en Figure 2, chacun des quatre bras d'accrochage 16 s'étendent symétriquement par rapport à quatre demi plans méridiens 26 passant par l'axe optique 14 et incliné chacun de 30° par rapport à un plan de symétrie 27 par rapport auquel la lentille 12 est pliée pour faciliter son insertion dans l'oeil grâce à une seringue d'injection. Lors du pliage autour du plan 27, les bras d'accrochage 16 qui sont flexibles s'étendent sur la droite et la gauche de la Figure 2 de manière à ne pas dépasser du diamètre extérieur 28 de la lentille 12.As illustrated in Figure 2 , each of the four attachment arms 16 extend symmetrically with respect to four meridian half-planes 26 passing through the optical axis 14 and each inclined by 30 ° with respect to a plane of symmetry 27 with respect to which the lens 12 is folded to facilitate insertion into the eye with an injection syringe. When folding around the plane 27, the attachment arms 16 which are flexible extend on the right and the left of the Figure 2 so as not to exceed the outer diameter 28 of the lens 12.

Une fois implantés dans le sac capsulaire 4, chacun des bras d'accrochage 16 reprennent leur position de repos telle qu'illustrée aux Figures 1 et 2. Les fonds de centrage 18 de chacun des éléments de centrage/accrochage 23 sont situés le long du cercle de référence 24.Once implanted in the capsular bag 4, each of the attachment arms 16 resume their rest position as illustrated in FIGS. Figures 1 and 2 . The centering funds 18 of each of the centering / hooking elements 23 are located along the reference circle 24.

Une fois implantés dans l'oeil, le chirurgien peut, avec un outil, attraper chacun des bras d'accrochage et l'amener chacun vers l'axe optique 14 de manière que le guide extérieur 17 puisse ressortir du sac capsulaire 4 et que le fond de centrage 18 vienne alors en appui sur le pourtour 10 de l'orifice obtenu par capsulorhexie.Once implanted in the eye, the surgeon can, with a tool, catch each of the attachment arms and bring it each towards the optical axis 14 so that the outer guide 17 can emerge from the capsular bag 4 and that the centering bottom 18 comes then bearing on the periphery 10 of the orifice obtained by capsulorhexie.

Chacun des bras d'accrochage 16 présente une largeur qui décroît progressivement de 9 mm à 5 mm de large au fur et à mesure du pied 22. L'épaisseur varie également de 1 mm à 0,6 mm. On comprend que de tels bras d'accrochage présentent une raideur s'opposant au déplacement axial de l'élément de centrage/ accrochage 23 inférieur à la raideur latérale s'opposant à un déplacement de ce même élément de centrage 23 dans un plan parallèle au plan médian 13. Une telle configuration permet à la fois un bon centrage de la lentille 12 par rapport au pourtour capsulorhexis 10 tout en permettant une légère tension axiale des chambres postérieure et antérieure 8, 7.Each of the attachment arms 16 has a width which gradually decreases from 9 mm to 5 mm wide as the foot 22. The thickness also varies from 1 mm to 0.6 mm. It is understood that such attachment arms have a stiffness opposing the axial displacement of the centering / latching element 23 less than the lateral stiffness opposing a displacement of the same centering element 23 in a plane parallel to the median plane 13. Such a configuration allows both a good centering of the lens 12 relative to the circumference capsulorhexis 10 while allowing a slight axial tension of the posterior and anterior chambers 8, 7.

Comme illustré en Figure 3, un deuxième mode de réalisation comprend quatre bras d'accrochage 40 situés à 90° les uns des autres et présentant une grande largeur, par exemple de l'ordre de 14 mm. Cela vient renforcer la qualité du centrage de la lentille 12 par rapport au capsulorhexis 10.As illustrated in Figure 3 a second embodiment comprises four attachment arms 40 located at 90 ° from each other and having a large width, for example of the order of 14 mm. This reinforces the quality of the centering of the lens 12 with respect to the capsulorhexis 10.

Le pied de raccordement 42 du bras d'accrochage 40 s'étend latéralement de part et d'autre du plan méridien de manière à cantonner le pied de raccordement 42 le plus près possible de la zone périphérique 21 de la lentille 12.The connecting leg 42 of the attachment arm 40 extends laterally on either side of the meridian plane so as to encircle the connecting leg 42 as close as possible to the peripheral zone 21 of the lens 12.

Comme illustré en Figure 4, un troisième mode de réalisation est constitué de plusieurs bras d'accrochage 50 jumelés entre eux, deux par deux, par un pont 51 de raccordement des guides extérieurs 52. Ce mode de réalisation présente à la fois des bras d'accrochage plus souples susceptibles de se plier davantage pour faciliter l'insertion dans le sac capsulaire tout en permettant au chirurgien de positionner simultanément deux bras d'accrochage 50 en raison du pont de raccordement 51.As illustrated in Figure 4 a third embodiment consists of several attachment arms 50 paired together, two by two, by a bridge 51 for connecting the outer guides 52. This embodiment has both more flexible attachment arms susceptible to bend further to facilitate insertion into the capsular bag while allowing the surgeon to simultaneously position two latching arms 50 due to the connecting bridge 51.

Comme illustré en Figure 5, les bras de raccordement 60 sont également jumelés deux par deux tout en étant encore plus souples.As illustrated in Figure 5 , the connecting arms 60 are also paired in pairs while being even more flexible.

On comprendra que les différents modes de réalisation évoqués peuvent être combinés entre eux, on peut par exemple faire varier la larguer de chacun des bras de raccordement ainsi que leur forme. De même, les bras d'accrochage 16, 50, 60 pourraient aussi être équipés de pied de raccordement élargis latéralement et réduit radialement.It will be understood that the various embodiments mentioned can be combined with one another, for example the drop of each of the connecting arms can be varied as well as their shape. Similarly, the attachment arms 16, 50, 60 could also be equipped with laterally widened connecting foot and reduced radially.

Dans une autre variante, le nombre de bras d'accrochage 6, ou 40, ou 50 peut être par exemple de trois ou de six.In another variant, the number of attachment arms 6, or 40, or 50 may be for example three or six.

Claims (10)

Implant intraoculaire (11) destiné à une implantation dans l'oeil (1) après une capsulorhexie de la capsule antérieure (7), comprenant : - une lentille unique (12) s'étendant dans un plan médian (13) et présentant un axe optique (14) normal au plan médian ainsi qu'une face postérieure destinée à être plaquée sur la capsule postérieure, - l'implant comprenant en outre une partie haptique (15) comprenant des guides intérieurs (19) reliés à la lentille (12) par un ou plusieurs bras de raccordement flexibles (20), l'implant présentant des moyens d'immobilisation de la lentille (12) dans le sac capsulaire (4) de l'oeil,
caractérisé en ce que les moyens d'immobilisation comprennent lesdits guides intérieurs (19), lesdits bras flexibles et au moins une portion de la face postérieure (31) de la lentille, et sont conçus pour tendre la capsule antérieure (7) et la capsule postérieure (8) une fois que l'implant est en position,
en ce que la partie haptique (15) comprend une pluralité d'éléments de centrage/accrochage (23) et un cercle de référence (24) le long duquel s'étend un fond de centrage (18) de chacun des éléments de centrage/accrochage, le cercle de référence (24) étant parallèle et à distance axiale du plan médian (13) de la lentille (12);
et en ce que les éléments de centrage/accrochage (23) présentent chacun un desdits guides intérieurs (19) et un guide extérieur (17) s'étendant radialement au-delà du fond de centrage (18) et sont destinés à entourer la capsule antérieure (7) respectivement à l'intérieur et à l'extérieur du sac capsulaire (4), le pourtour (10) de l'orifice de la capsule antérieure obtenu par capsulorhexie venant en appui sur les fonds de centrage (18).
An intraocular implant (11) for implantation in the eye (1) after capsulorhexia of the anterior capsule (7), comprising: a single lens (12) extending in a median plane (13) and having an optical axis (14) normal to the median plane and a posterior surface intended to be plated on the posterior capsule, the implant further comprising a haptic portion (15) comprising inner guides (19) connected to the lens (12) by one or more flexible connecting arms (20), the implant having means for immobilizing the lens (12) in the capsular bag (4) of the eye,
characterized in that the immobilizing means comprise said inner guides (19), said flexible arms and at least a portion of the posterior face (31) of the lens, and are adapted to tension the anterior capsule (7) and the capsule posterior (8) once the implant is in position,
in that the haptic portion (15) comprises a plurality of centering / hooking elements (23) and a reference circle (24) along which a centering bottom (18) of each of the centering elements / hooking, the reference circle (24) being parallel and at an axial distance from the median plane (13) of the lens (12);
and in that the centering / hooking elements (23) each have one of said inner guides (19) and an outer guide (17) extending radially beyond the centering bottom (18) and are intended to surround the capsule anterior (7) respectively inside and outside of the capsular bag (4), the periphery (10) of the aperture of the capsule capsulorhexie former abutting on the centering funds (18).
Implant selon la revendication 1, dans lequel chaque bras de raccordement s'étend jusqu'à une distance de l'axe optique conçue pour qu'une fois implanté dans l'oeii, l'implant reste à une distance radiale prédéterminée non nulle du diamètre équatorial du sac cristallinien.Implant according to claim 1, wherein each connecting arm extends to a distance from the optical axis designed so that once implanted in the oeii, the implant remains at a predetermined radial non-zero diameter distance equatorial of the crystalline sac. Implant selon l'une des revendications précédentes, dans lequel le guide extérieur (17), le fond de centrage (18) et le guide intérieur (19) de chacun des éléments de centrage/accrochage (23) sont de formes symétriques par rapport à un même plan méridien (26) de l'élément de centrage/accrochage (23).Implant according to one of the preceding claims, wherein the outer guide (17), the centering bottom (18) and the inner guide (19) of each of the centering / hooking elements (23) are of symmetrical shapes with respect to the same meridian plane (26) of the centering / hooking element (23). Implant selon l'une des revendications précédentes,, dans lequel le guide extérieur (17) présente une extrémité distale libre et un arrondi (25) en regard du guide intérieur (19), la distance axiale entre l'extrémité distale et le guide intérieur en regard étant inférieure à l'épaisseur moyenne d'une capsule antérieure d'oeil humain, de façon à constituer un moyen de clipsage de la capsule antérieure (7).Implant according to one of the preceding claims, wherein the outer guide (17) has a free distal end and a rounded (25) facing the inner guide (19), the axial distance between the distal end and the inner guide opposite being lower than the average thickness of an anterior capsule of human eye, so as to constitute a means of clipping the anterior capsule (7). Implant selon l'une des revendications précédentes, dans lequel la partie haptique (15) est constituée par une pluralité de bras d'accrochage (16,40,50,60), constitués chacun par l'un des éléments de centrage/accrochage et par un unique bras de raccordement (20) à la lentille (12), lui aussi de forme symétrique par rapport au plan méridien (26) de l'élément de centrage/accrochage (23).Implant according to one of the preceding claims, wherein the haptic portion (15) is constituted by a plurality of attachment arms (16,40,50,60), each constituted by one of the centering / hooking elements and by a single connecting arm (20) to the lens (12), also of symmetrical shape with respect to the meridian plane (26) of the centering / hooking element (23). Implant selon l'une des revendications précédentes, dans lequel chaque bras de raccordement (20) est relié à une zone périphérique (21) de la lentille (12).Implant according to one of the preceding claims, wherein each connecting arm (20) is connected to a peripheral zone (21) of the lens (12). Implant selon l'une des revendications précédentes, dans lequel chaque bras de raccordement (20) est relié à une face antérieure (33) de la lentille (12) située du même coté du plan médian (13) que le cercle de référence (24).Implant according to one of the preceding claims, wherein each connecting arm (20) is connected to an anterior face (33) of the lens (12) located on the same side of the median plane (13) as the reference circle (24). ). Implant selon l'une des revendications précédentes, dans lequel chaque bras de raccordement (20) s'étend à moins de 4,2 mm de l'axe optique (14).Implant according to one of the preceding claims, wherein each connecting arm (20) extends less than 4.2 mm from the optical axis (14). Implant selon l'une des revendications précédentes, dans lequel la lentille (12) présente un bord latéral (30) cylindrique et une face postérieure (31) destinée à être plaquée contre la capsule postérieure (8) de l'oeil, le bord cylindrique (30) et la face postérieure (31) étant raccordés par une arrête vive (32).Implant according to one of the preceding claims, wherein the lens (12) has a cylindrical lateral edge (30) and a posterior face (31) intended to be pressed against the posterior capsule (8) of the eye, the cylindrical edge (30) and the rear face (31) being connected by a sharp edge (32). Implant selon la revendication 9, dans lequel le bord latéral cylindrique (30) s'étend axialement entre 150 et 300 µm.Implant according to claim 9, wherein the cylindrical lateral edge (30) extends axially between 150 and 300 μm.
EP11175244A 2010-07-27 2011-07-25 Intraocular implant with attachment elements Withdrawn EP2412337A1 (en)

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FR1056166A FR2963229B1 (en) 2010-07-27 2010-07-27 INTRAOCULAR IMPLANT WITH HANGING ELEMENTS.

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Also Published As

Publication number Publication date
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FR2963229A1 (en) 2012-02-03

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